Presenter Disclosures (1)The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: Sean O’Mahony

National Cancer Care: Best & Promising Practices for the LGBT Community APHA November 4, 2015 Radix Asa, Margolies Liz, Bare Michael, O’Mahony Sean, Maingi Shail

LGBT Communities and Cancer Disparities exist Disparities exist Providers know thisProviders know this A growing body of evidence indicates that LGBT communities are disproportionately affected by cancer due to higher rates of traditional risk factors such as tobacco and alcohol; barriers to cancer screening (e.g., healthcare-related stigma and discrimination); non- inclusion in education campaigns; and minority stress.A growing body of evidence indicates that LGBT communities are disproportionately affected by cancer due to higher rates of traditional risk factors such as tobacco and alcohol; barriers to cancer screening (e.g., healthcare-related stigma and discrimination); non- inclusion in education campaigns; and minority stress. Supporting data is scant Supporting data is scant 55 studies55 studies HIV-, STI-relatedHIV-, STI-related National Databases: Data EmergesNational Databases: Data Emerges Lesbians and Breast Cancer Rates Lesbians and Breast Cancer Rates Lower screening rates Lower screening rates Worse outcomes—lower rates of treatment completion, survelliance Worse outcomes—lower rates of treatment completion, survelliance

2014: Summit on Cancer in LGBT Communities 60 international researchers, survivors, funders, CBOs, and health care providers met 60 international researchers, survivors, funders, CBOs, and health care providers met Tasked with outlining the nature and extent of the problems that exist Tasked with outlining the nature and extent of the problems that exist Priority issues: Priority issues: Intersectionality emphasized as a core principleIntersectionality emphasized as a core principle Exclusion in databasesExclusion in databases Exclusion and funding for researchExclusion and funding for research Lack of LGBTQ culturally competent workforceLack of LGBTQ culturally competent workforce Little intake of LGBTQ information at time of clinical encounterLittle intake of LGBTQ information at time of clinical encounter

Best and Most Promising Practices For the LGBT Community Across the Cancer Continuum In 2014 and 2015 expert panel convened twice In 2014 and 2015 expert panel convened twice CDC-, HealthLinks-, and National LGBT Cancer Network-Funded CDC-, HealthLinks-, and National LGBT Cancer Network-Funded To develop the best and most promising practices across the cancer care continuum for the LGBT community. To develop the best and most promising practices across the cancer care continuum for the LGBT community. The experts drew upon available literature, clinical and community experience and reached a consensus regarding recommendations The experts drew upon available literature, clinical and community experience and reached a consensus regarding recommendations Recommendations were then rigorously reviewed and revised Recommendations were then rigorously reviewed and revised

Cancer Care Continuum Model

Five Cross-Cutting Issues 1. Sexual Orientation and Gender Identity (SOGI) Data Collection 2. LGBT Culturally Competent Workforce 3. LGBT Culturally Competent Health Care Systems 4. Patient/client Information and Education 5. Diversity and Intersectionality

Goals for the Best Practice Encouraging disclosure of layered LGBT identities Encouraging disclosure of layered LGBT identities Recognizing the diverse family and support systems of choice in LGBT communities Recognizing the diverse family and support systems of choice in LGBT communities Understanding the role of social determinants of health for LGBT individuals and communities Understanding the role of social determinants of health for LGBT individuals and communities Addressing the multiple stigmas many LGBT patients experience in healthcare Addressing the multiple stigmas many LGBT patients experience in healthcare Sensitivity to comorbidities in the LGBT health disparities, including those diagnoses overrepresented in the LGBT communities Sensitivity to comorbidities in the LGBT health disparities, including those diagnoses overrepresented in the LGBT communities

Health Promotion / Cancer Prevention

Public Health Recommendations Aimed towards public health departments Aimed towards public health departments Across the cancer continuum Across the cancer continuum

How to Use Best & Promising Practices

LGBT Best and Promising Practices Cancer Committee Members

Thank Everyone Involved Francisco Buchting Francisco Buchting Liz Margolies and the staff of the National LGBT Cancer Network Liz Margolies and the staff of the National LGBT Cancer Network Scout and the staff at LGBT HealthLink Scout and the staff at LGBT HealthLink